Intraoperative radiotherapy in brain metastasis surgery allows faster transition to systemic therapy.

IF 2.5 Q2 CLINICAL NEUROLOGY

Neuro-oncology practice Pub Date : 2025-01-27 eCollection Date: 2025-08-01 DOI:10.1093/nop/npaf012

Philipp Krauss, Christina Wolfert, Jason Bakos, Bastian Stemmer, Georg Stueben, Klaus Henning Kahl, Ehab Shiban

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引用次数: 0

Abstract

Background: In patients with brain metastases (BMs), delay of systemic therapy (CTX) after oncologic surgery due to wound healing issues and postoperative radiotherapy might influence the oncologic outcome. Intraoperative radiotherapy (IORT) is an emerging option in neurooncology, possibly shortening the time for comprehensive treatment compared to conventional external beam radiotherapy (EBRT). The aim of this study was to compare the transition time to CTX in patients undergoing IORT or EBRT.

Methods: We performed a retrospective chart review analysis of patients undergoing surgery for BMs at our institution with either IORT or adjuvant EBRT. Either therapy was applied according to an internal standard operation procedure favoring IORT if feasible. The time (days) from surgery until the beginning of CTX was compared together with overall hospitalization time.

Results: Ninety-nine patients were analyzed from which 59 underwent adjuvant EBRT and 40 IORT. Patients undergoing resection of BMs with IORT had significantly shorter intervals to CTX (EBRT vs. IORT; 65.4 ± 54.3 days vs. 32.3 ± 28.0 days (mean±SD); P < .001). Comparing the interval to CTX between the last EBRT fraction and IORT showed no significant difference EBRT vs. IORT (26.2 ± 55.8 days vs. 32.3 ± 28.0 days (mean±SD); P = .52). The time spent hospitalized until CTX was significantly lower in the IORT group (EBRT vs. IORT 20.2 ± 9.4 days vs. 9.5 ± 7.1 days (mean±SD); P < .001).

Conclusions: IORT for BM surgery allows a faster transition to systemic oncologic therapy than conventional adjuvant EBRT.

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脑转移手术中的术中放疗可以更快地过渡到全身治疗。

背景：在脑转移（BMs）患者中，肿瘤手术后由于伤口愈合问题和术后放疗而延迟全身治疗（CTX）可能会影响肿瘤预后。术中放疗（IORT）是神经肿瘤学的一种新兴选择，与传统的外束放疗（EBRT）相比，可能缩短综合治疗的时间。本研究的目的是比较接受IORT或EBRT的患者向CTX的过渡时间。方法：我们对我院接受脑转移手术的患者进行了回顾性图表分析，这些患者要么接受IORT治疗，要么接受辅助EBRT治疗。任何一种治疗都是根据内部标准操作程序进行的，如果可行的话，支持IORT。从手术到CTX开始的时间（天）与总住院时间进行比较。结果：分析99例患者，其中59例行辅助EBRT， 40例行IORT。接受脑转移切除术并进行IORT的患者到CTX的间隔时间明显缩短(EBRT vs. IORT；65.4±54.3天vs. 32.3±28.0天（平均±SD）；p = .52)。IORT组住院至CTX的时间显著低于EBRT组（20.2±9.4天）和IORT组（9.5±7.1天）；结论：与传统的辅助EBRT相比，BM手术中的IORT可以更快地过渡到全身肿瘤治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuro-oncology practice CLINICAL NEUROLOGY-

CiteScore

5.30

自引率

11.10%

发文量

期刊介绍： Neuro-Oncology Practice focuses on the clinical aspects of the subspecialty for practicing clinicians and healthcare specialists from a variety of disciplines including physicians, nurses, physical/occupational therapists, neuropsychologists, and palliative care specialists, who have focused their careers on clinical patient care and who want to apply the latest treatment advances to their practice. These include: Applying new trial results to improve standards of patient care Translating scientific advances such as tumor molecular profiling and advanced imaging into clinical treatment decision making and personalized brain tumor therapies Raising awareness of basic, translational and clinical research in areas of symptom management, survivorship, neurocognitive function, end of life issues and caregiving